Covid has outlasted our patience to fight it. But vaccination rates are a misleading gauge of progress. Until infection rates actually ebb, restrictions should continue.

(Originally published Nov. 1 in “What in the World“) Remember the pandemic? Much of the world seems to be doing its best to pretend it’s over and move on to longer-term problems. But Covid-19 continues to find new people to infect.

Luckily, momentum is building for rich nations to stop dithering on promises to get vaccines to the 4.7 billion people who still haven’t been vaccinated. One hundred former national leaders sent an open letter to the host of last week’s G20 Summit in Rome, Italian Prime Minister Mario Draghi, urging him to get the G20 to transfer unused doses to poorer nations still struggling to get supplies. The letter was clearly part of a highly scripted, multilateral narrative. So it’s little surprise that the G20 seemed to have responded on this issue in its declaration concluding the Summit:

“Recognizing that vaccines are among the most important tools against the pandemic,
and reaffirming that extensive COVID-19 immunization is a global public good, we will advance our efforts to ensure timely, equitable and universal access to safe, affordable, quality and effective vaccines, therapeutics and diagnostics, with particular regard to the needs of low- and middle-income countries. To help advance toward the global goals of vaccinating at least 40 percent of the population in all countries by the end of 2021 and 70 percent by mid-2022, as recommended by the World Health Organization (WHO)’s global vaccination strategy, we will take steps to help boost the supply of vaccines and essential medical products and inputs in developing countries and remove relevant supply and financing constraints. We ask our Health Ministers to monitor progress toward this end and to explore ways to accelerate global vaccination as necessary.”

Problem solved! Let’s move on to Glasgow to talk about fixing the climate.

Meanwhile, the coronavirus isn’t yet submitting to our best efforts to contain it. Given enough infections, it will keep evolving and potentially reach a new form that evades our vaccines. In fact, it already has. The latest surge in new infections is often called a “pandemic of the unvaccinated,” but evidence is growing that vaccinated people are serving as asymptomatic carriers of the virus, i.e. they are getting infected, even if they aren’t necessarily getting severely ill. Vaccines are highly effective against infection by the Delta strain of Covid-19, but not 100%.

Vaccination rates also tend to overstate the level of protection in any population because they exclude a sizeable group of people still ineligible for inoculation: children. This helps explain the persistent surge of infections in the UK despite its high vaccination uptake. It also means that until we can manage to vacccinate kids, they provide a very effective reservoir to the virus. Kids can get infected without appearing ill, and thus keep transmitting the virus to older people and give the virus yet more opportunities to mutate.

The result is a surge in infections in countries that are relaxing precautions against transmission after achieving high vaccination rates, like Singapore and Germany. The vaccinated majority and unvaccinated minority are mingling with greater frequency, which multiplies the opportunities for the virus to infect both the unvaccinated and that small proportion of vaccinated still susceptible to it.

Restrictions on gathering, traveling and mask wearing shouldn’t be lowered until both vaccination rates are up and infection rates are low.